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Just a Spoonful of Sugar: Tips for Giving Medicine to Kids

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by Suzanne Dixon, M.D., M.P.H.,
and  Angela Rosas, M.D..


Many new parents (and some experienced ones, too) are uncertain about how to give medicine to babies and young children. The secret is believing that the child needs the medicine. A child can sense any doubts in your mind and will resist no matter what you do, unless you sincerely believe you're doing what is best. Be confident and determined. If you aren't convinced the medicine is necessary, talk to your child's health care provider first, rather than trying half-heartedly to get it into your child.

If your child hates taking the medicine and both you and his medical provider believe the medication is essential, consult your provider and your pharmacist. Ask about alternative medications that have less volume per dose, have to be taken less often, or score higher on the taste test. A different form might help — some kids do better with a tablet crushed and hidden in food than with a funny-tasting liquid.

  General Tips for Making the Medicine Go Down

  Infants

  Toddlers and Preschoolers

  School-Aged Children




General Tips for Making the Medicine Go Down

  • Make sure your child is standing or sitting up at least a 45-degree angle when taking any medicine. This reduces the risk of choking.
  • Give liquid medicine along the side of the mouth, about halfway down. If it goes directly to the center of your child's palate, it will trigger a gag. Place tablets on the back of the tongue or they will be spit out.
  • Disguise a medicine's bad taste when possible. Favorite vehicles include applesauce, yogurt, pudding, smooth peanut butter (for kids 18 months and older), and jam. For the most resistant cases, try soft candy pieces, ice cream, or chocolate syrup.
  • Mixing a medication with a liquid such as juice, formula, or milk can be problematic because a significant part of the medicine will be left coating the cup, glass, or bottle. If you use a liquid to dilute medicine, use a small amount and be sure all of it gets into your child.
  • If you use a spoon, use the measuring type — it's more accurate than ordinary tableware. Better yet, use a plastic medicine spoon with dosage markings.
  • Never refer to medicine as candy — you're setting up a potentially dangerous confusion. Tell it like it is.
  • Never allow a child younger than a teenager to take his medicine unsupervised for any reason.
  • Don't bargain or bribe. The stakes will just escalate. Also, you give the message that taking medicine is a negotiable activity when it really isn't. Give your child some choice in the situation — such as what cup he wants to drink a chaser from or what room he wants to take his medicine in — but don't imply that anyone has a choice about whether he will take the medicine.
  • Don't punish a child who refuses to take medicine. Most medicine tastes nasty, and we're all programmed to avoid bitter tastes, which are generally poisons when found in nature. Just insist and plow ahead. And when the mission has been accomplished, don't forget the BIG hug and congratulations on a job well done — for both of you!
Here are some specific strategies and techniques based on your child's age.


Infants

Hold your baby at a 45-degree angle, with his hands down and head supported. Using a plastic syringe, a medicine dropper, or a nipple from a bottle, drip the medicine onto the back of his tongue near the sides. Avoid emptying the dropper into his cheek pouches, because your baby will surely spit it all out at his first opportunity. Also avoid squirting the medicine down into your baby's throat, because he might choke. Give him a chaser of milk or juice.


Toddlers and Preschoolers

You can reduce the bad taste of some liquid medicines in several ways.

  • Chill the medicine, or have your child suck on a Popsicle or ice chips prior to taking the medicine. Then use a favorite cold drink as a chaser. Cold temperatures numb the taste buds.
  • Mix the medicine with a strongly flavored food such as chocolate pudding or Kool-Aid powder. Make sure your child eats all of the mixed food. You can also dilute the medicine in a strong-tasting liquid such as apple juice, as long as your child will drink all of it (see above).
Children ages 1 to 4 are the ones most likely to out and out refuse to take medicine. Children that age have strong feelings about what they eat and drink and are often wary even of things that we think taste good. Listening to your child's feelings about taking medicine before you attempt to give it will often take the edge off of strong resistance. If you continue to be firm about the need to take the medicine while continuing to listen, you may be amazed by the cooperation you eventually gain from your child.

As a very last resort, you should hold your child and give the medicine, but this is quite disempowering to a child, and listening first will probably work better. If you have another adult with you, one adult can bear-hug the child, holding his arms down and his head at a 45-degree angle. The other adult gives the medicine as described above for infants with a plastic syringe. If you are the only adult around at medication time, you can roll your child in a sheet or blanket like a papoose with his arms down, while holding him up at 45-degree angle, and then give the medicine with a plastic syringe (see above).

Afterward, praise your child for taking the medicine, but let him know that you will hold him again for the next dose if he refuses. Give him the choice of taking the medicine himself or being held.


School-Aged Children
Kids this age can understand why the medicine is necessary and feel more in control of taking it. They can even take medicine themselves while an adult supervises. If your child is reluctant to take medicine, you can use a star chart and reward him for taking a single dose or a day's worth of medicine. If bad-tasting liquids and chewables are the problem, see whether your child is ready to swallow pills.

Children can learn to swallow pills starting at age 4, but more typically will master this when they are grade-schoolers, around 7 or 8 years old. To teach this skill, have your child practice swallowing a small lump of soft food without chewing. Gradually move up to small hard foods that will dissolve quickly if they get stuck, like small ice chips. When the time comes to take medicine, try small pills whole or large pills cut in half or quartered before you expect the whole thing to go down.

 
 
 
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